Latrobe Regional Gallery Cafe Space EOI Application Form

Please complete the below application to submit an expression of interest in operating the cafe space at Latrobe Regional Gallery.

Privacy Statement

Latrobe City Council is committed to the responsible handling of all personal information in accordance with privacy legislation.

Your personal information is collected by Council to enable us to provide services, activities and events to the local community, and carry out our statutory functions, including in relation to health and planning.

Council will collect information directly from you, where possible, and will not disclose personal information to any other party, except as allowed or required by law, without your consent.

If you require access to your personal information or if you have any questions please do not hesitate to contact Latrobe City Council’s Privacy Officer on 1300 367 700 or at PO Box 264 MORWELL VIC 3840.

For further information about how Council collects and manages personal information, please see the Latrobe City Council Privacy Policy available on our website.

Applicant Type

Company

Individual

Applicant Type - Company

Company Name

ABN

Company's Registered Address

City/Town

State/Province

ZIP/Postal Code

Registered for GST?

Yes

Director Name (1)

Address

City/Town

State/Province

ZIP/Postal Code

Director Name (2)

Address

City/Town

State/Province

ZIP/Postal Code

Applicant Type - Individual

First

Last

ABN

Address

City/Town

State/Province

ZIP/Postal Code

Registered for GST?

Yes

Applicant Contact Details

First

Last

Telephone

Business Details

Trading Name

Years in Operation

Type of Business

Address

City/Town

State/Province

ZIP/Postal Code

Number of Years at this Address

Current Rent

Current Landlord/ Agent

Landlord's Address

City/Town

State/Province

ZIP/Postal Code

Landlord Contact Name

Landlord Contact Number

Required References

Applicants Can NOT be considered without the following references being provided.

Accountant Name

Address

City/Town

State/Province

ZIP/Postal Code

Business Reference 1

Contact Name

Contact Number

Business Reference 2

Contact Name

Contact Number

Note – a business reference is a company, supplier or contractor that the applicant holds an account with and who supplies a product or service to the applicant’s business.

Submission Documents

Current Public Liability Insurance Certificate